POS1338 CENTRAL SENSITIZATION AND RELATED FACTORS IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
Authors: F. N. Yücel, H. H. Gezer, J. Jandaulyet, N. Öz, S. Acer Kasman, M. T. Duruöz
Journal: Annals of the Rheumatic Diseases (2022)

Background Central sensitization (CS) is an increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input is an important manifestation involved in many different rheumatic diseases [1]. Objectives This study aims to investigate the CS in patients with Familial Mediterranean Fever (FMF) and its associations with other parameters. Methods This ongoing study included 73 patients (57 female, 16 male) who were diagnosed with FMF according to the Tel-Hashomer criteria. Clinical characteristics including age, gender, disease duration, age at onset, genetic mutations, comorbid disease and medications were noted. Disease activity was assessed with a PRAS disease activity score. Evaluations included the Health Assessment Questionnaire (HAQ), FMF quality of life (FMF-QoL), Pittsburg Sleep Quality Index (PSQI), Fibromyalgia Rapid Screening Tool (FiRST), and the Hospital Anxiety and Depression Scale (HADS). The symptoms of CS were assessed with the Central Sensitization Inventory (CSI; range 0-100) which is a self-report outcome measure designed to identify patients who have symptoms that may be related to CS or central sensitivity syndromes (CSS) such as fibromyalgia, neck injury, temporomandibular joint disorder or migraine/tension headaches [2]. Descriptive analysis was performed for all parameters. The Mann-Whitney U-test and chi-squared test were used in statistical analysis. P&lt;0.05 was considered statistically significant. Results The mean age of the patients was 37.6 (SD:13.6) years. Sacroiliitis occurred in 8 patients (11%), amyloidosis in 1 (1.4%), and erysipelas-like erythema in 8 (11%). The most prevalent genetic mutation was M694/any compound heterogeneous (16.4%) followed by M69V homogeneous (15.1%). Disease activity was mild in 42.5%, moderate in 32.9% and severe in 12.3% of the patients. The mean CSI was 38.4 (SD:18.7) and thirty-four (46.6 %) of 73 patients had CS according to the CSI. CSI scores were significantly higher in females than in males (p=0.009). Eleven (15%) patients had colchicine resistance, and those with colchicine resistance had significantly higher CS scores. In patients with central sensitization, PRAS, HAQ FMF-QoL, FiRST, PSQI, and HADS scores were significantly higher than in patients without central sensitization (Table 1). Table 1. Disease characteristics in terms of central sensitization Central sensitization Yes (n=34 ) Central sensitization No (n=39 ) p Gender, female 31 (91.2%) 26 (66.7%) 0.02 BMI, kg/m 2 28.8 (8.8) 26.2 (6.8) 0.282 Disease duration 9.3 (6.9) 12.9 (9.9) 0.156 Number of attacks in the last 3 months 2.05 (2.1) 0.8 (1.6) &lt;0.001 Number of attacks in the last 6 months 3.7 (3.3) 1.5 (3.2) &lt;0.001 PRAS 6.3 (2.1) 4.8 (2.3) 0.004 HAQ 0.4 (0.6) 0.08 (0.2) FMF-QoL 38.2 (13.7) 17.3 (15.2) &lt;0.001 FiRST 3.9 (1.9) 1.7 (1.7) &lt;0.001 PSQI 9.9 (3.9) 6.4 (2.8) &lt;0.001 HAD-Anxiety 9.6 (4.4) 4.9 (3.8) &lt;0.001 HAD-Depression 7.08 (4) 4.4 (3.2) 0.003 BMI: Body Mass Index, HAQ: Health Assessment Questionnaire, FiRST: Fibromyalgia Rapid Screening Tool, FMF-QoL: Familial Mediterranean Fever Quality of Life, PSQI: The Pittsburgh Sleep Quality Index, HADS: the Hospital Anxiety and Depression Scale Conclusion CS is present in approximately half of FMF patients. CS in patients with FMF was associated with high disease activity, fibromyalgia, anxiety, depression, impaired function, poor quality of life and sleep. References [1]Adami G, Gerratana E, Atzeni F, et al. Is central sensitization an important determinant of functional disability in patients with chronic inflammatory arthritides?. Ther Adv Musculoskelet Dis . 2021;13:1759720X21993252. Published 2021 Feb 15. doi:10.1177/1759720X21993252 [2]Neblett R, Cohen H, Choi Y, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain . 2013;14(5):438-445. doi:10.1016/j.jpain.2012.11.012 Disclosure of Interests None declared